Periodontal regeneration of an anterior intrabony defect using the whale's tail technique: A case report

Background: Management of intrabony periodontal defects in the esthetic zone remains one of the most demanding procedures in periodontal therapy because successful treatment requires not only regeneration of the periodontal attachment apparatus but also preservation of interdental soft tissue architecture. Vertical osseous defects between the maxillary central incisors frequently present with pathologic tooth migration and midline diastema, adversely affecting esthetics and patient confidence. Various papilla-preserving surgical techniques have been proposed to improve regenerative outcomes. Among them, the Whale's Tail technique provides excellent access to anterior intrabony defects while maintaining primary flap closure and minimizing postoperative flap dehiscence. Case Presentation: A 45-year-old female presented with the chief complaint of spacing between the upper central incisors that had gradually increased over several months, causing significant esthetic concern. Clinical examination revealed a papillary frenal attachment associated with a 7-mm periodontal pocket between teeth 11 and 21. Intraoral periapical radiography demonstrated a localized vertical intrabony defect extending into the interdental alveolar bone. Following completion of Phase I periodontal therapy, regenerative periodontal surgery was performed using the Whale's Tail flap design. Thorough debridement of the osseous defect was followed by placement of regenerative graft material and tension-free primary wound closure.Results: Healing progressed uneventfully throughout the postoperative period. At the three-month follow-up, probing pocket depth was reduced from 7 mm to 3 mm with satisfactory soft-tissue healing and maintenance of the interdental papilla. Radiographic evaluation demonstrated increased radiopacity within the defect, suggestive of favorable bone fill and early periodontal regeneration.Conclusion: The Whale's Tail technique facilitated excellent surgical access while preserving interdental tissues and ensuring primary closure over the regenerative material. Favorable early clinical and radiographic outcomes indicate that this technique may be an effective treatment option for localized anterior intrabony defects associated with midline diastema.